An Overview and Management of Painful Menstrual Disorder (Dysmenorrhea): A Narrative Literature Review

This narrative literature review describes painful menstrual disorder (dysmenorrhea), distinguishing primary dysmenorrhea, attributed to prostaglandin release in ovulatory cycles without pelvic disease, from secondary dysmenorrhea, linked to pelvic pathology that can arise in later reproductive years. It reports that dysmenorrhea affects about 90% of women, with roughly 15% experiencing pain severe enough to prevent activities for 1–3 days, and notes that primary dysmenorrhea often begins in adolescence. The review states that nonsteroidal anti-inflammatory drugs (NSAIDs) are the treatment of choice because they reduce cyclooxygenase (COX) activity and thereby prostaglandin production, and highlights that NSAIDs are most effective when initiated at the first sign of bleeding or cramping. This paper is centrally about dysmenorrhea; relevance to endometriosis: it explicitly lists secondary dysmenorrhea as associated with pelvic diseases including endometriosis and adenomyosis.

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